Liao Zhongli, Hu Xiaogang, Hu Liuling, Yang Jian
Department of Clinical Nutrition, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Gastroenterology, Chongqing University Cancer Hospital, Chongqing, China.
Eur J Med Res. 2025 Jan 10;30(1):23. doi: 10.1186/s40001-024-02266-9.
Hemorrhagic chronic radiation proctitis (CRP) is a common and challenging complication after pelvic radiation therapy. Identifying high-risk factors, predicting its occurrence, and optimizing radiotherapy plans are key to preventing hemorrhagic CRP. This study retrospectively examined potential risk factors and developed a nomogram to predict its onset.
This retrospective study included cervical carcinoma patients who received pelvic radiotherapy at Chongqing University Cancer Hospital from March 2014 to December 2021. Hemorrhagic CRP was diagnosed by colonoscopy. Logistic regression identified factors for a nomogram model, which was evaluated using ROC curve, calibration curve, and decision curve analysis.
Among 221 patients, 125 were diagnosed with hemorrhagic CRP, occurring at a median of 14.45 months after pelvic radiotherapy. Age (≥ 54 years), weight (< 52 kg), and radiation dose (≥ 72 Gy) were identified as risk factors. A nomogram was developed, with AUC values of 0.741 and 0.74 in the training and validation cohorts. Decision and clinical impact curves showed the model's benefit over a probability range of 0.25 to 0.85 in both sets.
In this study, we constructed and developed a nomogram for predicting hemorrhagic CRP risk. The good results in calibration curves, ROC curve analysis, and decision curves indicated that the nomogram had promise for clinical application. It may serve as a reference for radiologists in designing radiotherapy plan to help mitigate the risk of hemorrhagic CRP.
出血性慢性放射性直肠炎（CRP）是盆腔放疗后常见且具有挑战性的并发症。识别高危因素、预测其发生并优化放疗计划是预防出血性CRP的关键。本研究回顾性分析了潜在风险因素并构建了列线图以预测其发病。
本回顾性研究纳入了2014年3月至2021年12月在重庆大学附属肿瘤医院接受盆腔放疗的宫颈癌患者。通过结肠镜检查诊断出血性CRP。逻辑回归确定列线图模型的因素，并使用ROC曲线、校准曲线和决策曲线分析进行评估。
221例患者中，125例被诊断为出血性CRP，发生在盆腔放疗后中位时间14.45个月。年龄（≥54岁）、体重（<52kg）和放疗剂量（≥72Gy）被确定为风险因素。构建了列线图，训练队列和验证队列的AUC值分别为0.741和0.74。决策曲线和临床影响曲线显示该模型在两组中0.25至0.85的概率范围内均有益处。
在本研究中，我们构建并开发了一种预测出血性CRP风险的列线图。校准曲线、ROC曲线分析和决策曲线的良好结果表明该列线图具有临床应用前景。它可为放射科医生设计放疗计划提供参考，以帮助降低出血性CRP的风险。
